Preoperative Factors Affecting the Outcome of Mitral Valve Replacement in Patients with Chronic Mitral Regurgitation

Sohn, Jeong Ho; Kim, Kee Sik; Shin, Kyeung Mok; Hur, Seung Ho; Kim, Yoon Nyun; Kim, Kwon Bae

Abstract

BACKGROUND
Mitral regurgitation is a valvular heart disease that produce complex hemodynamic alternations and myocardial dysfunction occurs subclinically, so result in a high incidence of left ventricular dysfunction that might affect postoperative result. In order to assess preoperative factors affecting the outcome of mitral valve replacement in patients with chronic mitral regurgitaion, we evaluated prognostic factors from preoperative clinical, laboratory, and echocardiographic findings in 71 patients with chronic mitral regurgitation who received mitral valve replacement.
METHODS
From 1985 to 1994, 71 patients with chronic mitral regurgitation, who received mitral valve replacement, were included in this study. The patients were defined as group I who had improved symptom and / or decreased left ventricular end-diastolic dimension after operation, and group II who had persistent symptom and / or over 60mm of left ventricular end-diastolic dimension after operation.
RESULTS
1) In clinical findings, preoperative systolic blood pressure was higher in Group I patients(p<0.05). 2) Hemoglobin, serum creatinine, and blood urea nitrogen level were not significantly different in both groups. 3) In echocardigraphic findings, left atrial dimension, left ventricular end-systolic / end-diastolic dimension, and left ventricular volume index of Group II were much higher than those of Group I patients(p<0.05). 4) In the discriminant analysis, left ventricular end-diastolic dimension, age, NYHA functional class, and left ventricular mass index were defined as important prognostic factors.
CONCLUSION
According to the above results, preoperative age, NYHA functional class are significant prognostic factors in clinical and laboratory findings. And left atrial dimension, left ventricular end-systolic and end-diastolic dimensions, left ventricular volume index, and left ventricular mass index are significant prognostic factors in echocardiographic findings.